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General NPI Number Information
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NPI Number | 1811511777
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Entity Type | Individual
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Provider Name | ALEC RADULSKI PHARMD
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Gender | Male
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Dates
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Enumeration Date | 06/05/2020
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Last Update Date | 06/05/2020
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Provider Practice Location Address
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Address Line | 817 E SHOTWELL ST
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City | BAINBRIDGE
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State | GA
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Zip | 39819-4145
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Country | US
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Telephone | 292-243-0373
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Fax |
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Provider Business Mailing Address
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Address Line | 139 SINCLAIR RD
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City | TALLAHASSEE
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State | FL
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Zip | 32312-2714
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Country | US
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Telephone | 850-345-2668
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH031663
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS58587
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License Number State | FL
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